Frequently Asked Questions
Frequently Asked Questions
- I am from Out of Town. Does this present any difficulties with my Care?
- How many resurfacing procedures have you performed?
- Do you perform hip resurfacing procedures for women?
- Can you perform joint implant surgery for patients with metal sensitivity?
- What is the advantage of hip resurfacing over hip replacement?
- Why should I come to your program for care?
- Will insurance pay for my care?
- Can I play sports after a joint resurfacing procedure?
- Will I still have my knee ligaments with a knee resurfacing procedure?
- Will my hip come out of joint after a resurfacing procedure?
- Will my new joint last as long as I do?
- How long will I be away from work?
- How long will I be in bed after surgery?
- Will my surgery be "less invasive"?
- Will I receive new technology?
- Will my joint be replaced?
- How long will I be in the hospital?
- Which hospital will be used?
- Will there be a need for banking of my own blood, or do you use a blood salvaging technique?
- How many BHR resurfacings have you performed?
- Will my implant be Metal on Metal? Is there a problem with this?
- Have you had any failed procedures?
- Do you have experience with revising hip resurfacing procedures?
- Did you use any recalled prostheses?
- When did you complete you BHR training?
- What would be my "window of opportunity" time frame for having hip resurfacing?
- Is hip resurfacing new?
- My orthopedic surgeon does not recommend hip resurfacing. Why?
- Do you see an increased risk of loosening of the cup component due to bone stock, and would that be the same for resurfacing as for total hip replacement?
- Are there issues for resurfacing due to leg length?
- With hip dysplasia, do you anticipate any need for bone grafting or screw fixation in the cup component?
- What will the availability of the devices be in the next six months?
- Do you use spinal or general anesthesia resurfacing surgery?
- How long does an average resurfacing procedure take?
- Which incision approach would you use for a case such as mine?
- What do you use to close the incision?
- Do you anticipate any post-op weight-bearing restrictions?
- What are your other post-op restrictions and for how long?
- How many resurfacings have you performed on dysplasia patients and how many of those would you consider successful?
- How many planned resurfacings have you had to convert to THR during surgery?
- How many THR's a year/month do you perform?
- When did you complete your BHR training with Ronan Treacy?
- Can you provide your personal statistics on your resurfacing successes and failures?
- What are the statistics of getting a post-operative infection at the hospital?
- Is there an increased risk of AVN with a femoral head deformity?
- Is there a risk of dislocation?
- Is there a risk of nerve damage?
- Are there any unusual risks or complications as compared with THR?
- How long would you anticipate a resurfacing to last for me?
- Do you see a possibility of any unusual device wear or load issues?
- Should I go out of the Country for Hip Resurfacing?
- Is there anything I will not be allowed to do after my hip resurfacing procedure?
- Criteria for Resurfacing
- When Should a Resurfacing not be performed?
- Are there Alternatives to Metal for Resurfacing?
Most of our patients are from out of the area. We can accommodate your needs by collecting information in advance and coordinating your visits. Most patients make one trip to Seattle for the consultation and surgery and have a follow up visit and then rehabilitate under our supervision at home.
More than 5600. I also perform other procedures such as hip and knee replacement.
Yes. We perform nearly as many resurfacing procedures for women as men. Our results have been just as positive. More often women elect the soft polyethylene for their acetabular bearing.
We treat metal sensitive patients frequently and successfully but we use alternative bearing surfaces.
The functional outcomes are better, the recovery is shorter and the bone is preserved for future use.
We offer the most experience in joint implant procedures. We have a published peer reviewed tract record of success.
Essentially every major insurance plan pays for hip resurfacing surgery. We have a reduced payment plan for cash payment as well.
Yes. We do not limit patients from sports participation
If your ligaments are present (or have been reconstructed) they will be preserved to give your knee full stability.
There is a very small chance this could occur and only with an unusual movement or injury.
In the vast majority of cases the answer is yes. Unlike total hip replacement which may fail within 20 years, there is not finite life span for hip resurfacing. Typically the procedure will last as long as the bone remains healthy.
For sedentary jobs just a couple of weeks. For heavy work 4 to 6 weeks is recommended.
Just a matter of hours as the effects of anesthesia wear off. You can use your new joint right away.
Yes, new techniques limit the extent of surgery from what was done just a few years ago.
Yes, you will receive the newest metallurgy, ceramic or cross linked polyethylene.
No. Your joint will be resurfaced. The old term is still often used but almost all your bone is kept and only the damaged surface is replaced.
Almost all procedures are performed on an outpatient basis. The recovery is faster and the risk of blood clot and infection is lower on ambulatory cases.
The Swedish Orthopedic Institute or the Ambulatory Center.
No blood donation is necessary. Blood transfusions are not necessary.
We have used the BHR since it came to America in 2006. Before this we also used the Conserve Plus. We only offer surgery with FDA approved implants. We do not offer the Magnum from Biomet as it is not FDA approved. We use polyethylene, though, for most patients.
We offer procedures with both metal and polyethylene bearings for the socket. We have seen the occasional issue with metal sockets and we have been able to successfully revise these procedures.
Yes, but very few and many fewer than a reported in the major registries. We have been able to successfully revise the relatively few number of failed situations. It is rare for the procedure to fail completely and a partial revision is all that is typically needed. The recovery is shorter for most revision procedures.
We have extensive revision surgery experience. Some of the older implants did not perform at the same high level as current implants. We have experience with revising the ASR, Corin and Durom. The revision experience has been quite favorable with similar outcomes to primary cases.
No. We have revised recalled prosthesis but did not place any.
In 2006 (before the US release). I originally learned hip resurfacing from Dr. Townley in the 1980s as a resident trainee.
Anytime symptoms warrant. Patients need to have resurfacing procedures performed while their bone remains healthy.
No, but it has greatly improved as the result of better instruments, implants and knowledge.
Hip resurfacing is more difficult to perform and special training is required. It also lakes longer and we do not charge more for the procedure. Most surgeons find total hip replacement quite satisfactory.
Do you see an increased risk of loosening of the cup component due to bone stock, and would that be the same for resurfacing as for total hip replacement?
There are more options for cup fixation with total hip replacement although the risk of loosening should be minimal with resurfacing.
Leg length is not addressed with the resurfacing procedure. It is very unusual for patients to have a significant leg length issue after resurfacing. Patients often feel the leg is longer at first since the wear of the joint results in gradual shortening over the preceding months or years.
With hip dysplasia, do you anticipate any need for bone grafting or screw fixation in the cup component?
We have the ability to perform this if needed.
We have full availability of devices now. There are no new devices anticipated for release in the near term.
The surgery can be done with either anesthetic. The choice of anesthesia used is generally decided by the patient and the anesthesiologist. Most patients prefer a spinal anesthetic with sedation that has them asleep during the procedure.
Usually between 1 and 2 hours.
Either an Anterior or Superior approach can be used. Patients seem to recover patients recover better with the superior approach. While popular and easy for the surgeon our patients recover better without the HANA table. The have been injuries reported from the hyperextension and traction during surgery.
Usually intradermal sutures (they don't need to be removed).
Limit flexion to 90 degrees for one month.
How many resurfacings have you performed on dysplasia patients and how many of those would you consider successful?
Most of our patients have dysplasia and the results have been excellent.
None as of yet. We would do this though in the very unlikely event of an intraoperative fracture.
It varies. Have performed approximately 12,000 joint implant procedures.
January 2006. Trained on the TARA and C+ in the 1980's and 1990's.
See the articles posted on this site.
Less than a 1% chance.
Yes. There is still a small risk.
Yes, but this does not reach a percentage point as a risk. The risk is less than with total hip replacement.
Yes. Component positioning is more difficult with resurfacing.
The implants will not wear out. The main concern is the bone.
No. Hip resurfacing can be done here. We are concerned about the Americans that go abroad. We are not seeing that accurate follow-up of Americans that have gone abroad is occurring.
No. We have a number of professional athletes from a variety of different sports
- Educated patient who understands the risks and procedures.
- Relative youth and need for high activity.
- Good bone quality.
- Limited deformity (major bone loss and leg shortening cannot be effectively addressed with resurfacing).
- When there is major bone loss.
- When there is insufficient experience of the surgical team.
- When there is renal insufficiency or certain other medical conditions.
We have performed more than 3200 hip resurfacing procedures using highly cross linked polyethylene over the last 14 years. We have no failures of this material (and none have been reported in the literature). Our wear simulator study found minimal wear in 30,000 cycles (equates to more than 20 years of active use in the body).